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Agenda
Reg Review
ICR
View Information Collection (IC)
View Information Collection (IC)
IC Title:
ASPR TRACIE COVID-19 HCC
Agency IC Tracking Number:
IC Status:
New
Obligation to Respond:
Voluntary
CFR Citation:
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Other-Survey
0990-0391 ASPR TRACIE Attachment A - COVID-19 HCC Survey.docx
Yes
Yes
Fillable Fileable
Other-Interview Guide
0990-0391 ASPR TRACIE Attachment B - COVID-19 HCC Interview Guide.docx
Yes
Yes
Fillable Fileable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Health Care Services
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
402
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
0 %
Approved
Program Change Due to New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
402
0
402
0
0
0
Annual IC Time Burden (Hours)
167
0
167
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
Recruitment Message
0990-0391 ASPR TRACIE Attachment C - COVID-19 HCC Recruitment Message.docx
03/25/2021
IC HCC COVID-19 Assessment
PRA Generic Form HCC COVID-19 Assessment 3.23.21.docx
03/25/2021
Part A - COVID-19 Healthcare Coalitions Survey and Interviews
SSA_0990-0391 Generic ASPR TRACIE COVID-19 HCC Surveys_Interviews 3.24.21.docx
03/25/2021
Part B - COVID-19 Healthcare Coalitions Survey and Interviews
SSB_0990-0391 Generic ASPR TRACIE COVID-19 HCC 3.23.21.docx
03/25/2021
IRB Approval
Tracie irb approval.pdf
04/05/2021
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
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